Provider Demographics
NPI:1306433701
Name:HESS, RACHEL ANNETTE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNETTE
Last Name:HESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27508 KIME HOLDERMAN RD
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-8952
Mailing Address - Country:US
Mailing Address - Phone:740-612-9591
Mailing Address - Fax:
Practice Address - Street 1:27508 KIME HOLDERMAN RD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-8952
Practice Address - Country:US
Practice Address - Phone:740-612-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7100890Medicaid